Needles and syringes distributed per person who injects drugs
Progress in improving the coverage of needles and syringes provided, an essential HIV prevention service for people who inject drugs
Injecting drug use is one of the main routes through which people acquire HIV globally. Preventing HIV transmission caused by injecting drug use is one of the key challenges in reducing the burden of HIV.
Needle–syringe programmes are included as an essential health sector intervention in the World Health Organization (WHO) comprehensive package of interventions for HIV prevention and treatment among key populations (see further information below) described in the Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations (2022).
Needle–syringe programmes greatly enhance HIV prevention for people who inject drugs, and a wealth of scientific evidence supports their efficacy in preventing the spread of HIV
Number of needles and syringes distributed in the past 12 months by needle-syringe programmes
Number of people who inject drugs in the country
For the numerator: Programme data used to count the number of needles and syringes distributed
For the denominator: Estimation of the number of people who inject drugs in the country
- Type of provider (public services, key population-led organization, NGOs, or other entities). Please see page 33 in the complementary document Global AIDS Monitoring Framework 2022-2026 for additional guidance.
- Name of the organization/s. Please indicate the name and URL/website (if available) of the key population-led organization, NGOs, or other entities that are providing these services.
If there are subnational data available, please provide the disaggregation by administrative area, city, or site in the space provided. You may also upload an Excel spreadsheet of these data instead of entering them in the online tool. Submit the digital version of any available size estimation reports using the upload tool.
Some difficulties in counting needles and syringes are reported. Some commonly used syringes are 1 ml or 2 ml needle and syringe units; others are syringes to which needles need to be fitted. In most cases, only data on the number of syringes distributed by needle-syringe programmes but not pharmacy sales are available.
Estimating the number of people who inject drugs at the country level presents challenges. People who inject drugs are defined in many ways, and the estimates have ranges. The UNODC publishes estimates of the number of people who inject drugs in the World drug report. These estimates may be used. If there is a reason not to use them, please provide the rationale in the comment field.
Countries that have legalized sales of needles and syringes without a prescription may appear to have artificially low coverage with this indicator. Countries can monitor this indicator against the following coverage levels:
- Low: <100 syringes per person who injects drugs per year.
- Medium: 100–200 syringes per person who injects drugs per year.
- High: >200 syringes per person who injects drugs per year.
These levels are based on studies in low- and middle-income countries investigating the levels of syringe distribution and how these affect HIV transmission. The levels required for preventing hepatitis C are likely to be much higher than those presented here.
Tool to set and monitor targets for HIV prevention, diagnosis, treatment and care for key populations: supplement to the 2014 consolidated guidelines for HIV prevention, diagnosis, treatment and care for key populations. Geneva: World Health Organization; 2015 (https://apps.who.int/iris/bitstream/handle/10665/177992/9789241508995_en...).
Effectiveness of sterile needle and syringe programming in reducing HIV/AIDS among IDUs. Geneva: World Health Organization; 2004 https://www.who.int/hiv/pub/prev_care/effectivenesssterileneedle.pdf
WHO/UNAIDS Working Group on Global HIV/AIDS and STI Surveillance.Guidelines on estimating the size of populations most at risk to HIV. Geneva: World Health Organization and UNAIDS; 2010 (https://data.unaids.org/pub/manual/2010/guidelines_popnestimationsize_en...).
Consolidated guidelines on person-centred HIV strategic information: strengthening routine data for impact. Geneva: World Health Organization, 2022 (https://www.who.int/publications/i/item/9789240055315). Global HIV Strategic Information Working Group. Biobehavioural survey guidelines for populations at risk for HIV. Geneva: World Health Organization; 2017 (https://apps.who.int/iris/bitstream/handle/10665/258924/9789241513012-en...).